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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Withdrawal of antithrombotic agents and its impact on ischemic stroke occurrence

Joseph P Broderick1, Jordan B Bonomo, Brett M Kissela

  • 1University of Cincinnati, Department of Neurology, University of Cincinnati Neuroscience Institute, University of Cincinnati Academic Health Center MSB #0525, Cincinnati, OH 45242, USA. joseph.broderick@uc.edu

Stroke
|July 2, 2011
PubMed

Insights

Stopping antithrombotic medications like anticoagulants and antiplatelets within 60 days was linked to 5.2% of ischemic strokes. This highlights the importance of careful medication management to prevent strokes.

Area of Science:

  • Neurology
  • Cardiology
  • Public Health

Background:

  • Antithrombotic medications (anticoagulants, antiplatelets) are frequently paused during procedures or after bleeding events.
  • Patients may also discontinue these medications due to cost, side effects, or personal choice.

Purpose of the Study:

  • To investigate the association between antithrombotic medication withdrawal and the occurrence of ischemic stroke.
  • To quantify the proportion of ischemic strokes temporally related to medication cessation.

Main Methods:

  • Utilized data from the Greater Cincinnati/Northern Kentucky Stroke Study (2005).
  • Reviewed patient records to identify ischemic strokes and their timing relative to antithrombotic medication withdrawal.
  • Classified reasons for medication stoppage (e.g., periprocedural, patient-initiated).

Main Results:

  • Identified 2197 ischemic strokes in 2005.
  • 5.2% (114 cases) of ischemic strokes occurred within 60 days of antithrombotic medication withdrawal.
  • Of these, 61 strokes followed warfarin withdrawal and the rest followed antiplatelet withdrawal.
  • Nearly half (47.4%) of strokes after withdrawal occurred during the periprocedural period.

Conclusions:

  • Withdrawal of antithrombotic medications within 60 days preceded 5.2% of ischemic strokes in the study population.
  • This underscores the critical need for judicious decision-making regarding periprocedural antithrombotic management.
  • Improving patient adherence to prescribed antithrombotic therapy is essential for stroke prevention.
Abstract

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